In the light of US Central Intelligence Agency guidelines that limited routine care of detainees to promote torture, our Zackary Berger, Leonard Rubenstein and Matthew DeCamp call for sanctions against health professionals who cooperate

In the light of US Central Intelligence Agency guidelines that limited routine care of detainees to promote torture, our Zackary Berger, Leonard Rubenstein and Matthew DeCamp call for sanctions against health professionals who cooperate

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.234567 Yet medical participation in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.891011 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees.

The 2016 release of previously classified portions of guidelines from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers.12

This document adds yet another disturbing element to our understanding of medical complicity in torture, suggesting a need to strengthen international and domestic ethical declarations to promote accountability for such complicity.13 As an executive order by the US President outlines continued transfer of prisoners to Guantanamo Bay,14 and the President has not ruled out the use of torture, a response becomes all the more urgent.

When my mother was in her final months, suffering from a heart failure and other problems, she called me to her bedside with a pained expression. She took my hand and asked plaintively, “How do I get out of this mess?”

When my mother was in her final months, suffering from a heart failure and other problems, she called me to her bedside with a pained expression. She took my hand and asked plaintively, “How do I get out of this mess?”

As a physician, I dreaded the question that might follow: Would I help her end her life by prescribing a lethal drug?

Fortunately for me, my mother tolerated her final weeks at home, with the help of hospice nurses and occasional palliative medication. She never raised the thorny question of what is variously termed “medical aid in dying” or “physician-assisted suicide.”

As a son and family member who has witnessed the difficult final days of parents and loved ones, I can understand why support for MAID/PAS is growing among the general public. But as a physician and medical ethicist, I believe that MAID/PAS flies in the face of a 2,000-year imperative of Hippocratic medicine: “Do no harm to the patient.”

Scientists are learning how weaning off opioids like morphine or fentanyl can be even more complicated than they thought. The narcotic painkillers are essential to dull the excrutiating pain that can follow things like surgery or cancer. When taken for more than a month, the medications risk causing more harm than good in a variety of ways. Travis Rieder knows first hand

Scientists are learning how weaning off opioids like morphine or fentanyl can be even more complicated than they thought. The narcotic painkillers are essential to dull the excrutiating pain that can follow things like surgery or cancer. When taken for more than a month, the medications risk causing more harm than good in a variety of ways. Travis Rieder knows first hand

Travis Rieder knows first hand. When he nearly lost his foot in a motorcycle accident in May 2015, Rieder was in agony. He needed opioids for pain from the both the crash and several surgeries to recover.

But two months after he starting taking the pain pills, he realized just how many he was consuming. Then, desperation sunk in.

Rieder says he was left to wean himself off the medication too quickly, without much guidance from his doctors.

He white-knuckled his way through physical dependence and withdrawal with the help of his wife and baby daughter.

‘ I thought that I was broken beyond repair and I was never going to be normal again.’– Travis Rieder

NEW YORK — Children whose sexual characteristics don’t neatly align with the norm have for decades faced surgery to rearrange their anatomy to resemble that of more typical boys and girls — long before they were old enough to have a say in the decision.

But now the practice is under assault, as never before. The American Medical Association is considering a proposal discouraging it.

Three former U.S. surgeons general say it’s unjustified. And on Tuesday, Human Rights Watch and InterACT a group advocating for intersex youth — are releasing a detailed report assailing the practice and urging Congress to ban it.